Risk factors of central line-associated bloodstream infection_West China Medical Journal

Authors：

CHEN Jing , XIANG Qian , WU Jiayu ,  XIAO Na

Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

XIAO Na, Email: 45940547@qq.com

Keywords：

Central venous catheter; central line-associated bloodstream infection; risk factor

DOI：

10.7507/1002-0179.202301059

Video：

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Objective To investigate the risk factors of central line-associated bloodstream infection (CLABSI) and provide clinical guidance for reducing the incidence of CLABSI. Methods The clinical data of patients with central venous catheter catheterization in Sichuan Provincial People’s Hospital between January 2018 and December 2021 were retrospectively collected. According to whether CLABSI occurred, the patients were divided into CLABSI group and non-CLABSI group. The data of patients were analyzed and the risk factors of CLABIS were discussed. Results A total of 43 987 patients were included. Among them, there were 63 cases in the CLABSI group and 43924 cases in the non-CLABSI group. The incidence of CLABSI was 0.18/1 000 catheter days. Multivariate logistic regression analysis showed that admission to intensive care unit (ICU) [odds ratio (OR)=74.054, 95% confidence interval (CI) (22.661, 242.005), P<0.001], hemodialysis [OR=4.531, 95%CI (1.899, 10.809), P=0.001] and indwelling catheter days [OR=1.017, 95%CI (1.005, 1.029), P=0.005] were independent risk factors for CLABSI. A total of 63 strains of pathogenic bacteria were isolated from the 63 patients with CLABSI. Among them, 28 strains of Gram-positive bacteria, 25 strains of Gram-negative bacteria and 10 strains of Candida. Conclusions Admission to ICU, hemodialysis and long-term indwelling catheter are independent risk factors for CLABSI. The prevention and control measures of CLABSI should be strictly implemented for such patients to reduce the risk of infection.

Citation： CHEN Jing, XIANG Qian, WU Jiayu, XIAO Na. Risk factors of central line-associated bloodstream infection. West China Medical Journal, 2023, 38(3): 370-373. doi: 10.7507/1002-0179.202301059 Copy

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5.	Goudie A, Dynan L, Brady PW, et al. Attributable cost and length of stay for central line-associated bloodstream infections. Pediatrics, 2014, 133(6): e1525-e1532.
6.	Higuera F, Rangel-Frausto MS, Rosenthal VD, et al. Attributable cost and length of stay for patients with central venous catheter-associated bloodstream infection in Mexico City intensive care units: a prospective, matched analysis. Infect Control Hosp Epidemiol, 2007, 28(1): 31-35.
7.	Mayer J, Greene T, Howell J, et al. Agreement in classifying bloodstream infections among multiple reviewers conducting surveillance. Clin Infect Dis, 2012, 55(3): 364-370.
8.	Selby LM, Rupp ME, Cawcutt KA. Prevention of central-line associated bloodstream infections: 2021 update. Infect Dis Clin North Am, 2021, 35(4): 841-856.
9.	Paioni P, Kuhn S, Strässle Y, et al. Risk factors for central line-associated bloodstream infections in children with tunneled central venous catheters. Am J Infect Control, 2020, 48(1): 33-39.
10.	Machat S, Eisenhuber E, Pfarl G, et al. Complications of central venous port systems: a pictorial review. Insights Imaging, 2019, 10(1): 86.
11.	O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis, 2011, 52(9): e162-e193.
12.	Gao Y, Liu Y, Ma X, et al. The incidence and risk factors of peripherally inserted central catheter-related infection among cancer patients. Ther Clin Risk Manag, 2015, 11: 863-871.
13.	Miliaraki M, Katzilakis N, Chranioti I, et al. Central line-associated bloodstream infection in childhood malignancy: single-center experience. Pediatr Int, 2017, 59(7): 769-775.
14.	Vassallo M, Genillier PL, Dunais B, et al. Short-course daptomycin lock and systemic therapy for catheter-related bloodstream infections: a retrospective cohort study in cancer patients with surgically implanted devices. J Chemother, 2017, 29(4): 232-237.
15.	Krishnan A, Irani K, Swaminathan R, et al. A retrospective study of tunnelled haemodialysis central line-associated bloodstream infections. J Chemother, 2019, 31(3): 132-136.

1. Kim JS, Holtom P, Vigen C. Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: epidemiologic and economic consequences. Am J Infect Control, 2011, 39(8): 640-646.
2. Rosenthal VD, Bijie H, Maki DG, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009. Am J Infect Control, 2012, 40(5): 396-407.
3. Ling ML, Apisarnthanarak A, Madriaga G. The burden of healthcare-associated infections in southeast Asia: a systematic literature review and Meta-analysis. Clin Infect Dis, 2015, 60(11): 1690-1699.
4. Stevens V, Geiger K, Concannon C, et al. Inpatient costs, mortality and 30-day re-admission in patients with central-line-associated bloodstream infections. Clin Microbiol Infect, 2014, 20(5): O318-O324.
5. Goudie A, Dynan L, Brady PW, et al. Attributable cost and length of stay for central line-associated bloodstream infections. Pediatrics, 2014, 133(6): e1525-e1532.
6. Higuera F, Rangel-Frausto MS, Rosenthal VD, et al. Attributable cost and length of stay for patients with central venous catheter-associated bloodstream infection in Mexico City intensive care units: a prospective, matched analysis. Infect Control Hosp Epidemiol, 2007, 28(1): 31-35.
7. Mayer J, Greene T, Howell J, et al. Agreement in classifying bloodstream infections among multiple reviewers conducting surveillance. Clin Infect Dis, 2012, 55(3): 364-370.
8. Selby LM, Rupp ME, Cawcutt KA. Prevention of central-line associated bloodstream infections: 2021 update. Infect Dis Clin North Am, 2021, 35(4): 841-856.
9. Paioni P, Kuhn S, Strässle Y, et al. Risk factors for central line-associated bloodstream infections in children with tunneled central venous catheters. Am J Infect Control, 2020, 48(1): 33-39.
10. Machat S, Eisenhuber E, Pfarl G, et al. Complications of central venous port systems: a pictorial review. Insights Imaging, 2019, 10(1): 86.
11. O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis, 2011, 52(9): e162-e193.
12. Gao Y, Liu Y, Ma X, et al. The incidence and risk factors of peripherally inserted central catheter-related infection among cancer patients. Ther Clin Risk Manag, 2015, 11: 863-871.
13. Miliaraki M, Katzilakis N, Chranioti I, et al. Central line-associated bloodstream infection in childhood malignancy: single-center experience. Pediatr Int, 2017, 59(7): 769-775.
14. Vassallo M, Genillier PL, Dunais B, et al. Short-course daptomycin lock and systemic therapy for catheter-related bloodstream infections: a retrospective cohort study in cancer patients with surgically implanted devices. J Chemother, 2017, 29(4): 232-237.
15. Krishnan A, Irani K, Swaminathan R, et al. A retrospective study of tunnelled haemodialysis central line-associated bloodstream infections. J Chemother, 2019, 31(3): 132-136.

West China Medical Journal

Risk factors of central line-associated bloodstream infection

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